克拉玛依市老年人认知减退、抑郁状态现状分析及影响因素的研究

A Study on the Current Status and Influencing Factors of Cognitive Decline and Depressive State among the Elderly in Karamay City

摘要: 目的：本研究旨在探究克拉玛依市65岁以上老年人认知减退及抑郁状态的现状，并剖析其影响因素，为社区开展老年人认知减退及抑郁状态的早期干预提供科学依据。方法：研究采用简单随机抽样与分层抽样相结合的方式，选取13,286名65岁以上老人作为调查对象，借助AD8、PHQ-9自评工具进行手机问卷调查。结果：13,286名调查对象中，认知功能下降组有3819人(占比28.745%)，认知功能正常组9467人(占比71.255%)，认知功能下降组年龄显著高于正常组(P < 0.01)；可能或已处于抑郁状态组1954人(占比14.707%)，无抑郁组11,332人(占比85.293%)，抑郁组年龄显著高于正常组(P < 0.01)。认知功能下降组和正常组在年龄、性别、婚姻状况、居住方式、家庭月收入、既往史、家人健康状况、文化程度方面存在显著差异(均P < 0.05)。单因素Logistic回归分析表明，年龄、性别、婚姻状况、居住方式、家庭月收入、既往史、家人健康状况、文化程度是认知功能下降的风险因素；多因素Logistic回归分析显示，年龄、家庭月收入、既往史、家人健康状况、文化程度是认知功能下降的风险因素。可能或已处于抑郁状态组和正常组在年龄、性别、婚姻状况、家庭月收入、既往史、家人健康状况、文化程度方面差异显著(均P < 0.05)。单因素Logistic回归分析显示，上述因素是可能或已处于抑郁状态的风险因素；多因素Logistic回归分析表明，婚姻状况、家庭月收入、既往史、家人健康状况、文化程度是可能或已处于抑郁状态的风险因素。结论：克拉玛依市老年人认知功能障碍患病率为28.745%，独居、家庭月收入低、有既往慢性病史、家人健康状况差、文化程度低是老年人认知功能下降的高危因素；可能或已处于抑郁状态患病率为14.707%，性别、婚姻状况、家庭月收入低、既往有慢性病史、家人健康状况差、文化程度低是抑郁障碍的风险因素，需重点关注。

Abstract: Objective: This study aims to explore the current status of cognitive decline and depressive state among the elderly over 65 years old in Karamay City and analyze its influencing factors, so as to provide a scientific basis for the early intervention of cognitive decline and depressive state among the elderly in the community. Methods: The study adopted a combination of simple random sampling and stratified sampling to select 13,286 elderly people over 65 years old as the research objects, and used self-assessment tools such as AD8 and PHQ-9 for mobile phone questionnaires. Results: Among the 13,286 respondents, there were 3819 people in the cognitive function decline group (accounting for 28.745%), and 9467 people in the normal cognitive function group (accounting for 71.255%). The age of the cognitive function decline group was significantly higher than that of the normal group (P < 0.01). There were 1954 people in the possible or existing depressive state group (accounting for 14.707%), and 11,332 people in the non-depressive group (accounting for 85.293%). The age of the depressive group was significantly higher than that of the normal group (P < 0.01). There were significant differences between the cognitive function decline group and the normal group in terms of age, gender, marital status, living method, monthly family income, past medical history, family members’ health status, and educational level (all P < 0.05). Univariate Logistic regression analysis showed that age, gender, marital status, living method, monthly family income, past medical history, family members’ health status, and educational level were risk factors for cognitive function decline. Multivariate Logistic regression analysis showed that age, monthly family income, past medical history, family members’ health status, and educational level were risk factors for cognitive function decline. There were significant differences between the possible or existing depressive state group and the normal group in terms of age, gender, marital status, monthly family income, past medical history, family members’ health status, and educational level (all P < 0.05). Univariate Logistic regression analysis showed that the above-mentioned factors were risk factors for the possible or existing depressive state. Multivariate Logistic regression analysis showed that marital status, monthly family income, past medical history, family members’ health status, and educational level were risk factors for the possible or existing depressive state. Conclusion: The prevalence of cognitive impairment among the elderly in Karamay City is 28.745%. Living alone, low monthly family income, past chronic medical history, poor health status of family members, and low educational level are high-risk factors for cognitive function decline among the elderly. The prevalence of a possible or existing depressive state is 14.707%. Gender, marital status, low monthly family income, past chronic medical history, poor health status of family members, and low educational level are risk factors for depressive disorders, which require key attention.